The Worcester Venous Thromboembolism Study

伍斯特静脉血栓栓塞研究

基本信息

批准号：
7848341
负责人：
ROBERT JOEL GOLDBERG
金额：
$ 78.41万
依托单位：
UNIV OF MASSACHUSETTS MED SCH WORCESTER
依托单位国家：
美国
项目类别：
财政年份：
2003
资助国家：
美国
起止时间：
2003-04-01 至 2012-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7848341
关键词：
Acquired Immunodeficiency Syndrome Acute Address Age American Anticoagulant therapy Anticoagulation Area Biological Assay Blood Clot Blood coagulation Caring Case Fatality Rates Cessation of life Characteristics Cities Climacteric Clinic Clinical Clinical Treatment Clinics and Hospitals Cohort Studies Communities Comorbidity Data Data Collection Databases Deep Vein Thrombosis Development Diagnosis Diagnostic Diagnostic tests Disease Elderly Epidemiologic Studies Epidemiology Evaluation Fibrin fragment D Future Gender Goals Guidelines Health Health Maintenance Organizations Health Personnel Hemorrhage Heparin Hospitals Image Incidence Interruption Intervention Investigation Laboratories Leg Link Literature Low-Molecular-Weight Heparin Lung Malignant Neoplasms Massachusetts Measures Medical Medical History Medical Records Modality Monitor Morbidity - disease rate Natural History New England Newly Diagnosed Observational Study Outcome Outpatients Patient Self-Report Patients Pattern Physicians Population Population Study Populations at Risk Postphlebitic Syndrome Practice Management Prophylactic treatment Publishing Pulmonary Embolism Quality of life Recommendation Recording of previous events Recurrence Research Design Risk Severities Specific qualifier value Spiral Computed Tomography Staging Subgroup Symptoms Syndrome Telephone Interviews Testing Therapeutic Thromboembolism Thrombophilia Time Treatment outcome Ultrasonography Venous Warfarin abstracting adverse outcome base burden of illness clinical epidemiology cohort community setting computerized design follow-up health related quality of life high risk improved indexing insight malignant breast neoplasm medical specialties metropolitan mortality patient population population based prospective public health relevance secondary outcome treatment strategy trend

项目摘要

DESCRIPTION (provided by applicant): The overall aim of the proposed observational study is to continue population-based surveillance for monitoring trends in the incidence, management strategies, and recurrence and case-fatality rates associated with venous thromboembolism (VTE) in residents of a large metropolitan area. We will also perform prospective follow-up of a subset of patients diagnosed with VTE in 2009 and 2011. Despite advances in the diagnosis, prophylaxis, and treatment of this clinical syndrome, which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), VTE remains a significant cause of morbidity and mortality. Based on data from our initial study, the rates of recurrence of VTE after an initial diagnosis and the rates of bleeding related to VTE treatment remain unacceptably high. It has been estimated that annual mortality from VTE in Americans exceeds that of AIDS, breast cancer, and highway fatalities combined. This surveillance project will continue the follow-up of all residents of Worcester, MA diagnosed with DVT and/or PE during our 3 previous study years (1999, 2001, and 2003) with extension to 4 new study years (2005, 2007, 2009, and 2011). The overlapping components of this community-based study have been designed to provide complementary and inclusive information about the contemporary epidemiology of VTE including incidence rates, outcomes, physician management practices, and health-related quality of life (QOL), and changes over time therein. Detailed follow-up of our prospective cohorts will allow for more in-depth analysis of the natural history of VTE, its impact on health related QOL, duration and intensity of anticoagulation therapies employed, and evaluation of long-term medical care utilization patterns. The data provided from this study will be instrumental in identifying populations of patients with VTE at high risk for adverse outcomes, improper or underutilization of specific diagnostic testing or therapies, and contemporary outcomes. This information will set the stage for the design of targeted interventions to address shortcomings in current management practices with the goal of favorably influencing the long-term outcomes of patients with VTE. PUBLIC HEALTH RELEVANCE: It has been estimated that blood clots of the legs and lungs cause more deaths per year than AIDS, breast cancer, and highway fatalities combined. Data obtained from this study will allow for better estimates of the true burden of this disease in the U.S. as well as deficiencies in current management practices. This information will set the stage for future studies designed to address these shortcomings.

描述（由申请人提供）：拟议的观察性研究的总体目的是继续基于人群的监视，以监视与大都市地区居民的发病率，管理策略以及与静脉血栓栓塞（VTE）相关的病例型趋势的趋势。我们还将对2009年和2011年诊断为VTE的一部分患者进行前瞻性随访。尽管在诊断，预防和治疗该临床综合征的治疗方面取得了进步，其中包括深静脉血栓形成（DVT）和肺栓塞（PE），但VTE仍然是发射和死亡率的重要原因。根据我们最初的研究的数据，初始诊断后VTE的复发率以及与VTE治疗相关的出血率仍然不可接受。据估计，美国人中VTE的年死亡率超过了艾滋病，乳腺癌和高速公路死亡的总和。该监视项目将在我们的3个研究年度（1999，2001和2003）中诊断为DVT和/或PE的伍斯特所有居民的随访，并将其扩展到4个新研究年（2005年，2007年，2009年和2011年）。这项基于社区研究的重叠组成部分旨在提供有关当代VTE流行病学的补充和包容性信息，包括发病率，结果，医师管理实践和与健康相关的生活质量（QOL）以及随时间的变化。对我们前瞻性队列的详细随访将使对VTE的自然历史，其对健康相关QOL的影响，持续时间和抗凝治疗的强度以及对长期医疗保健利用模式的评估进行更深入的分析。这项研究提供的数据将有助于确定患有不良结果，特定诊断测试或疗法以及当代结果的VTE患者的种群。该信息将为设计有针对性干预措施的设计奠定阶段，以解决当前管理实践中的缺点，目的是有利地影响VTE患者的长期结局。公共卫生相关性：据估计，腿和肺的血块每年造成的死亡人数比艾滋病，乳腺癌和高速公路死亡人数多。从这项研究中获得的数据将允许更好地估计美国这种疾病的真正负担以及当前管理实践中的缺陷。这些信息将为未来的研究奠定舞台，旨在解决这些缺点。